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Anxiety disorders, obsessive compulsive disorder (OCD), and posttraumatic stress disorder (PTSD) are highly prevalent in older adults and significantly reduce quality of life. Yet, older adults are less likely to receive psychological interventions than adults of working age. In addition, anxiety disorders, OCD, and PTSD are poorly studied in older adults. While it is well established that psychological interventions are effective in the treatment of anxiety disorders, OCD, and PTSD in adults of working age (Carpenter et al., 2018), it is less well established whether these psychological interventions are also effective for older adults. Clinicians seem to share the idea that older adults with common mental disorders such as a depression or an anxiety disorder benefit less from psychological interventions compared to adults of working age (Kessler & Blachetta, 2020; Kessler & Schneider, 2019). However, the scientific evidence for these assumptions remains rather mixed (i.e., Hendriks, Oude Voshaar et al., 2008; Kishita & Laidlaw, 2017). The aim of this project is to investigate treatment outcomes of brief psychological interventions in generalized mental health care among older adults with anxiety disorders, OCD, or PTSD, and to compare these outcomes to younger adults.

This registration contains the pre-registration and materials for two studies. Research question 1 in the pre-registration is reported on in study 1. Research question 2 in the preregistration is reported on in study 2. Both studies will be written up in one manuscript.

Anxiety disorders and obsessive-compulsive disorders (OCD) are among the most common mental health issues worldwide (Ghaedi, Tavoli, Bakhtiari, Melyani, & Sahragard, 2010). Cognitive behavioral therapy (CBT) is the preferred treatment for patients with anxiety disorders or OCD. Even though CBT is effective for most patients, 30-40% of the patients do not respond to CBT (Durham, Chambers, MacDonald, Power, & Major, 2003). For those patients, often no alternative evidence-based psychological treatments are available. Therefore, new evidence-based therapies need to be developed. A new treatment program was developed for patients with an anxiety disorder or OCD and comorbid personality disorder: ‘SCHerp’ aims to reduce anxiety symptoms by combining and integrating schema therapy (SCH) with exposure and response prevention (erp). Previous observational research investigating the effectivity of SCHerp showed that 58.2% of the patients improved after treatment (Appel, Pranger, Stappenbelt, Burke, Van Passel, & Krans, submitted for publication). Although these results are promising, the SCHerp program can still be improved. The aim of this study is to evaluate, for each participant, the effectiveness of the SCHerp program in reducing both psychological malfunction and severity of disorder specific symptoms. In addition, we aim to evaluate changes in adaptive and maladaptive schema modes, and in implicit avoidance tendencies during the SCHerp program. Lastly, we aim to identify and generate hypotheses about periods within SCHerp with the highest gains (e.g. largest decline in anxiety/OCD symptoms) and provide insight into how changes in schema modes and disorder specific symptoms/psychological malfunction are associated in time.

Preregistration project "Age related differences in symptom networks of overall psychological functioning in a sample of anxiety, OCD, and PTSD patients".

Background Child abuse is a major global burden with an enduring negative impact on mental and physical health. A history of child abuse is consistently associated with worse cognitive performance among adults; data in older age groups are inconclusive. Since affective symptoms and cognitive functioning are interrelated among older persons, a synergistic effect can be assumed in patients with affective symptoms who also have suffered from child abuse. This study examines the association between a history of child abuse and cognitive performance in such patients. Methods Cross-sectional data were collected from the ‘Routine Outcome Monitoring for Geriatric Psychiatry & Science’ project, including 179 older adults (age 60–88 years) with either a unipolar depressive, any anxiety, or somatic symptom disorder referred to specialized geriatric mental health care. A history of physical, sexual, and psychological abuse, and emotional neglect was assessed with a structured interview. Cognitive functioning was measured with three paper and pencils tests (10-words verbal memory test, Stroop Colour-Word test, Digit Span) and four tests from the computerized Cogstate Test Battery (Detection Test, Identification Test, One Card Learning Test, One Back Test). The association between a history of child abuse and cognitive performance was examined by multiple linear regression analyses adjusted for covariates. Results Principal component analyses of nine cognitive parameters revealed four cognitive domains, i.e., visual-verbal memory, psychomotor speed, working memory and interference control. A history of child abuse was not associated with any of these cognitive domains. However, when looking at the specific types of child abuse separately, a history of physical abuse and emotional neglect were associated with poorer interference control. A history of physical abuse was additionally associated with better visual-verbal memory. Conclusions The association between a history of child abuse and cognitive performance differs between the different types of abuse. A history of physical abuse might particularly be a key determinant of cognitive performance in older adults with a depressive, anxiety, or somatic symptom disorder. Future studies on the impact of these disorders on the onset of dementia should take child abuse into account. Trial registration ROM-GPS is registered at the Dutch Trial Register (NL6704 at www.trialregister.nl).

Background: Guideline-recommended therapies are moderately successful in the treatment of obsessive-compulsive disorder (OCD) and anorexia nervosa (AN), leaving room for improvement. Cognitive inflexibility, a common trait in both disorders, is likely to prevent patients from engaging in treatment and from fully benefiting from existing therapies. Cognitive remediation therapy (CRT) is a practical augmentation intervention aimed at ameliorating this impairing cognitive style prior to disorder-specific therapy. Objective: To compare the effectiveness of CRT and a control treatment that was not aimed at enhancing flexibility, named specialized attention therapy (SAT), as add-ons to treatment as usual (TAU). Methods: In a randomized controlled multicenter clinical trial, 71 adult patients with OCD and 61 with AN were randomized to ten twice-weekly sessions with either CRT or SAT, followed by TAU. Patients were evaluated at baseline, post-CRT/SAT, and after 6 and 12 months, with outcomes being quantified using the Yale-Brown Obsessive Compulsive Scale for OCD and the Eating Disorder Examination Questionnaire for AN. Results: Across study groups, most importantly CRT+TAU was not superior to control treatment (SAT)+TAU in reducing OCD and AN pathology. Contrary to expectations, SAT+TAU may have been more effective than CRT+TAU in patients being treated for OCD. Conclusions: CRT did not enhance the effect of TAU for OCD and AN more than SAT. Unexpectedly, SAT, the control condition, may have had an augmentation effect on TAU in OCD patients. Although this latter finding may have been due to chance, the effect of SAT delivered as a pretreatment add-on intervention for adults with OCD and AN merits future efforts at replication.

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Contains fulltext : 50652.pdf (Publisher’s version ) (Closed access) To regulate mammalian water homeostasis, arginine-vasopressin (AVP) induces phosphorylation and thereby redistribution of renal aquaporin-2 (AQP2) water channels from vesicles to the apical membrane. Vice versa, AVP (or forskolin) removal and hormones activating PKC cause AQP2 internalization, but the mechanism is unknown. Here, we show that a fraction of AQP2 is modified with two to three ubiquitin moieties in vitro and in vivo. Mutagenesis revealed that AQP2 is ubiquitinated with one K63-linked chain at K270 only. In Madin-Darby canine kidney cells, AQP2 ubiquitination occurs preferentially when present in the apical membrane, is transiently increased with forskolin removal or PKC activation, and precedes its internalization. Internalization kinetics assays with wild type (wt) and ubiquitination-deficient (K270R) AQP2 revealed that ubiquitination enhances AQP2 endocytosis. Electron microscopy showed that a translational fusion of AQP2 with ubiquitin (AQP2-Ub) localized particularly to internal vesicles of multivesicular bodies (MVBs), whereas AQP2-K270R largely localized to the apical membrane, early endosomes, and the limiting membrane of MVBs. Consistent with this distribution pattern, lysosomal degradation was extensive for AQP2-Ub, low for AQP2-K270R, and intermediate for wt-AQP2. Our data show that short-chain ubiquitination is involved in the regulated endocytosis, MVB sorting, and degradation of AQP2 and may be the mechanism used by AVP removal and PKC-activating hormones to reduce renal water reabsorption. Moreover, because several other channels are also (short-chain) ubiquitinated, our data suggest that ubiquitination may be a general mediator for the regulated endocytosis and degradation of channels in higher eukaryotes.

We present a high-performance liquid chromatography (HPLC) method suitable for the analysis of epirubicin and its metabolite epirubicinol in saliva and plasma. Preparation of saliva and plasma samples was performed by extraction of analytes with a chloroform: 2-propanol mixture (6:1, vol/vol) and evaporation of the organic phase to dryness under vacuum at a temperature of approximately 45degreesC. The chromatographic analysis was carried out by reversed-phase isocratic elution of the anthracyclines with a Chromsep stainless steel HPLC column (150 x 4.6 mm I.D.) filled with Nucleosil 100 S C-18 material, particle size 5 mum. The detection was accomplished by spectrofluorimetry at excitation and emission wavelengths of 474 and 551 nm, respectively. The anthracyclines eluted within 10 min of injection, and the method appeared to be specific. The method is linear over a concentration range of 5 to 1000 mug/L for epirubicin and 2 to 400 mug/L for epirubicinol (r > 0.99) in both saliva and plasma. The recoveries from saliva and plasma of epirubicin, epirubicinol, and the internal standard doxorubicin were 88.9 and 69.0%, 87.6 and 77.3%, and 80 and 67.9%, respectively. The lower limit of quantification was 5 mug/L for epirubicin and 2 mug/L for epirubicinol. The method proved to be precise and accurate, as the within-day and between-day coefficients of variation were less than 10%. Overall results indicate that our method is suitable for the bioanalysis of epirubicin and epirubicinol in saliva as well as plasma.

Alhoewel terugwinning van fosfaat uit huishoudelijk afvalwater technisch zeer goed mogelijk is, zijn de kosten vele malen hoger dan de huidige prijs van het fosfaaterts. Een alternatieve en mogelijk goedkopere techniek is aluminiumprecipitatie van fosfaat uit de fosfaat-rijke waterstroom die bij biologische defosfatering ontstaat

International audience; In edge-weighted graphs, we provide a unified presentation of a family of popular morphological hierarchies such as component trees, quasi flat zones, binary partition trees, and hierarchical watersheds. For any hierarchy of this family, we show if (and how) it can be obtained from any other element of the family. In this sense, the main contribution of this paper is the study of all constructive links between these hierarchies.

International audience; The main question of this paper is to retrieve some continuity properties on (discrete) T0-Alexandroff spaces. One possible application, which will guide us, is the construction of the so-called ''tree of shapes'' (intuitively, the tree of level lines). This tree, which should allow to process maxima and minima in the same way, faces quite a number of theoretical difficulties that we propose to solve using set-valued analysis in a purely discrete setting. We also propose a way to interpret any function defined on a grid as a ''continuous'' function thanks to an interpolation scheme. The continuity properties are essential to obtain a quasi-linear algorithm for computing the tree of shapes in any dimension, which is exposed in a companion paper.

International audience; The goal of this paper is to provide linear or quasi-linear algorithms for producing some of the various trees used in mathematical morphology, in particular the trees corresponding to hierarchies of watershed cuts and hierarchies of constrained connectivity. A specific binary tree, corresponding to an ordered version of the edges of the minimum spanning tree, is the key structure in this study, and is computed thanks to variations around Kruskal algorithm for minimum spanning tree.

International audience; To compute the morphological self-dual representation of images, namely the tree of shapes, the state-of-the-art algorithms do not have a satisfactory time complexity. Furthermore the proposed algorithms are only effective for 2D images and they are far from being simple to implement. That is really penalizing since a self-dual representation of images is a structure that gives rise to many powerful operators and applications, and that could be very useful for 3D images. In this paper we propose a simple-to-write algorithm to compute the tree of shapes; it works for \nD images and has a quasi-linear complexity when data quantization is low, typically 12~bits or less. To get that result, this paper introduces a novel representation of images that has some amazing properties of continuity, while remaining discrete.